Maternal Diet Quality During Pregnancy and Offspring Hepatic Fat in Early Childhood: The Healthy Start Study

Catherine C. Cohen; Wei Perng; Katherine A. Sauder; Allison L.B. Shapiro; Anne P. Starling; Chloe Friedman; Janine F. Felix; Leanne K. Küpers; Brianna F. Moore; James R. Hébert; Nitin Shivappa; Ann Scherzinger; Shikha S. Sundaram; Kartik Shankar; Dana Dabelea

doi:10.1016/j.tjnut.2023.01.039

Maternal Diet Quality During Pregnancy and Offspring Hepatic Fat in Early Childhood: The Healthy Start Study

Catherine C. Cohen^*, Wei Perng, Katherine A. Sauder, Allison L.B. Shapiro, Anne P. Starling, Chloe Friedman, Janine F. Felix, Leanne K. Küpers, Brianna F. Moore, James R. Hébert, Nitin Shivappa, Ann Scherzinger, Shikha S. Sundaram, Kartik Shankar, Dana Dabelea

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › Academic › peer-review

1 Citation (Scopus)

Abstract

Background:

Overnutrition in utero may increase offspring risk of nonalcoholic fatty liver disease (NAFLD), but the specific contribution of maternal diet quality during pregnancy to this association remains understudied in humans. Objectives: This study aimed to examine the associations of maternal diet quality during pregnancy with offspring hepatic fat in early childhood (median: 5 y old, range: 4–8 y old)

Methods:

Data were from 278 mother–child pairs in the longitudinal, Colorado-based Healthy Start Study. Multiple 24-h recalls were collected from mothers during pregnancy on a monthly basis (median: 3 recalls, range: 1–8 recalls starting after enrollment), and used to estimate maternal usual nutrient intakes and dietary pattern scores [Healthy Eating Index-2010 (HEI-2010), Dietary Inflammatory Index (DII), and Relative Mediterranean Diet Score (rMED)]. Offspring hepatic fat was measured in early childhood by MRI. Associations of maternal dietary predictors during pregnancy with offspring log-transformed hepatic fat were assessed using linear regression models adjusted for offspring demographics, maternal/perinatal confounders, and maternal total energy intake.

Results:

Higher maternal fiber intake and rMED scores during pregnancy were associated with lower offspring hepatic fat in early childhood in fully adjusted models [Back-transformed β (95% CI): 0.82 (0.72, 0.94) per 5 g/1000 kcal fiber; 0.93 (0.88, 0.99) per 1 SD for rMED]. In contrast, higher maternal total sugar and added sugar intakes, and DII scores were associated with higher offspring hepatic fat [Back-transformed β (95% CI): 1.18 (1.05, 1.32) per 5% kcal/d added sugar; 1.08 (0.99, 1.18) per 1 SD for DII]. Analyses of dietary pattern subcomponents also revealed that lower maternal intakes of green vegetables and legumes and higher intake of “empty calories” were associated with higher offspring hepatic fat in early childhood.

Conclusions:

Poorer maternal diet quality during pregnancy was associated with greater offspring susceptibility to hepatic fat in early childhood. Our findings provide insights into potential perinatal targets for the primordial prevention of pediatric NAFLD.

Original language	English
Pages (from-to)	1122-1132
Number of pages	11
Journal	Journal of Nutrition
Volume	153
Issue number	4
DOIs	https://doi.org/10.1016/j.tjnut.2023.01.039
Publication status	Published - Apr 2023

Bibliographical note

Funding Information:
The Healthy Start Study was supported by National Institute of Diabetes, Digestive, and Kidney Disease (NIDDK) grant no. R01-DK076648 and National Insistutes of Health (NIH) Office of The Director grant no. UH3-OD023248 to DD. This work was also supported by National Center for Advancing Translational Sciences (NCATS) grant no. UL1-TR002535 to the Colorado Clinical Translational Sciences Institute and NIDDK grant no. P30-DK056350 to the University of North Carolina Nutrition Obesity Research Center. CCC was supported by NIDDK grant no. T32-DK07658 and F32-DK131757. WP was supported by NCATS grant no. KL2-TR002534. KS is supported in part by grants from the NIH (P30DK048520, R01DK121497, and R01ES032176). The work of JFF and LKK is supported by the European Union's Horizon 2020 research and innovation program (874739, LongITools) and the European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL, NutriPROGRAM project, ZonMw The Netherlands no. 529051022 and PREcisE project ZonMw The Netherlands no. 529051023). Contents are the authors’ sole responsibility and do not necessarily represent official NIH views.

Funding Information:
The Healthy Start Study was supported by National Institute of Diabetes, Digestive, and Kidney Disease (NIDDK) grant no. R01-DK076648 and National Insistutes of Health (NIH) Office of The Director grant no. UH3-OD023248 to DD . This work was also supported by National Center for Advancing Translational Sciences (NCATS) grant no. UL1-TR002535 to the Colorado Clinical Translational Sciences Institute and NIDDK grant no. P30-DK056350 to the University of North Carolina Nutrition Obesity Research Center. CCC was supported by NIDDK grant no. T32-DK07658 and F32-DK131757 . WP was supported by NCATS grant no. KL2-TR002534 . KS is supported in part by grants from the NIH ( P30DK048520 , R01DK121497 , and R01ES032176 ). The work of JFF and LKK is supported by the European Union’s Horizon 2020 research and innovation program ( 874739 , LongITools) and the European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL, NutriPROGRAM project, ZonMw The Netherlands no. 529051022 and PREcisE project ZonMw The Netherlands no. 529051023). Contents are the authors’ sole responsibility and do not necessarily represent official NIH views.

Publisher Copyright:
© 2023 American Society for Nutrition

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10.1016/j.tjnut.2023.01.039

Cite this

Cohen, C. C., Perng, W., Sauder, K. A., Shapiro, A. L. B., Starling, A. P., Friedman, C., Felix, J. F., Küpers, L. K., Moore, B. F., Hébert, J. R., Shivappa, N., Scherzinger, A., Sundaram, S. S., Shankar, K., & Dabelea, D. (2023). Maternal Diet Quality During Pregnancy and Offspring Hepatic Fat in Early Childhood: The Healthy Start Study. Journal of Nutrition, 153(4), 1122-1132. https://doi.org/10.1016/j.tjnut.2023.01.039

@article{9f97fc1cab3d4aebb50ebe8f5c570127,

title = "Maternal Diet Quality During Pregnancy and Offspring Hepatic Fat in Early Childhood: The Healthy Start Study",

abstract = "Background: Overnutrition in utero may increase offspring risk of nonalcoholic fatty liver disease (NAFLD), but the specific contribution of maternal diet quality during pregnancy to this association remains understudied in humans. Objectives: This study aimed to examine the associations of maternal diet quality during pregnancy with offspring hepatic fat in early childhood (median: 5 y old, range: 4–8 y old)Methods: Data were from 278 mother–child pairs in the longitudinal, Colorado-based Healthy Start Study. Multiple 24-h recalls were collected from mothers during pregnancy on a monthly basis (median: 3 recalls, range: 1–8 recalls starting after enrollment), and used to estimate maternal usual nutrient intakes and dietary pattern scores [Healthy Eating Index-2010 (HEI-2010), Dietary Inflammatory Index (DII), and Relative Mediterranean Diet Score (rMED)]. Offspring hepatic fat was measured in early childhood by MRI. Associations of maternal dietary predictors during pregnancy with offspring log-transformed hepatic fat were assessed using linear regression models adjusted for offspring demographics, maternal/perinatal confounders, and maternal total energy intake. Results: Higher maternal fiber intake and rMED scores during pregnancy were associated with lower offspring hepatic fat in early childhood in fully adjusted models [Back-transformed β (95% CI): 0.82 (0.72, 0.94) per 5 g/1000 kcal fiber; 0.93 (0.88, 0.99) per 1 SD for rMED]. In contrast, higher maternal total sugar and added sugar intakes, and DII scores were associated with higher offspring hepatic fat [Back-transformed β (95% CI): 1.18 (1.05, 1.32) per 5% kcal/d added sugar; 1.08 (0.99, 1.18) per 1 SD for DII]. Analyses of dietary pattern subcomponents also revealed that lower maternal intakes of green vegetables and legumes and higher intake of “empty calories” were associated with higher offspring hepatic fat in early childhood. Conclusions: Poorer maternal diet quality during pregnancy was associated with greater offspring susceptibility to hepatic fat in early childhood. Our findings provide insights into potential perinatal targets for the primordial prevention of pediatric NAFLD.",

author = "Cohen, {Catherine C.} and Wei Perng and Sauder, {Katherine A.} and Shapiro, {Allison L.B.} and Starling, {Anne P.} and Chloe Friedman and Felix, {Janine F.} and K{\"u}pers, {Leanne K.} and Moore, {Brianna F.} and H{\'e}bert, {James R.} and Nitin Shivappa and Ann Scherzinger and Sundaram, {Shikha S.} and Kartik Shankar and Dana Dabelea",

note = "Funding Information: The Healthy Start Study was supported by National Institute of Diabetes, Digestive, and Kidney Disease (NIDDK) grant no. R01-DK076648 and National Insistutes of Health (NIH) Office of The Director grant no. UH3-OD023248 to DD. This work was also supported by National Center for Advancing Translational Sciences (NCATS) grant no. UL1-TR002535 to the Colorado Clinical Translational Sciences Institute and NIDDK grant no. P30-DK056350 to the University of North Carolina Nutrition Obesity Research Center. CCC was supported by NIDDK grant no. T32-DK07658 and F32-DK131757. WP was supported by NCATS grant no. KL2-TR002534. KS is supported in part by grants from the NIH (P30DK048520, R01DK121497, and R01ES032176). The work of JFF and LKK is supported by the European Union's Horizon 2020 research and innovation program (874739, LongITools) and the European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL, NutriPROGRAM project, ZonMw The Netherlands no. 529051022 and PREcisE project ZonMw The Netherlands no. 529051023). Contents are the authors{\textquoteright} sole responsibility and do not necessarily represent official NIH views. Funding Information: The Healthy Start Study was supported by National Institute of Diabetes, Digestive, and Kidney Disease (NIDDK) grant no. R01-DK076648 and National Insistutes of Health (NIH) Office of The Director grant no. UH3-OD023248 to DD . This work was also supported by National Center for Advancing Translational Sciences (NCATS) grant no. UL1-TR002535 to the Colorado Clinical Translational Sciences Institute and NIDDK grant no. P30-DK056350 to the University of North Carolina Nutrition Obesity Research Center. CCC was supported by NIDDK grant no. T32-DK07658 and F32-DK131757 . WP was supported by NCATS grant no. KL2-TR002534 . KS is supported in part by grants from the NIH ( P30DK048520 , R01DK121497 , and R01ES032176 ). The work of JFF and LKK is supported by the European Union{\textquoteright}s Horizon 2020 research and innovation program ( 874739 , LongITools) and the European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL, NutriPROGRAM project, ZonMw The Netherlands no. 529051022 and PREcisE project ZonMw The Netherlands no. 529051023). Contents are the authors{\textquoteright} sole responsibility and do not necessarily represent official NIH views. Publisher Copyright: {\textcopyright} 2023 American Society for Nutrition",

year = "2023",

month = apr,

doi = "10.1016/j.tjnut.2023.01.039",

language = "English",

volume = "153",

pages = "1122--1132",

journal = "Journal of Nutrition",

issn = "0022-3166",

publisher = "American Society for Nutrition",

number = "4",

}

Cohen, CC, Perng, W, Sauder, KA, Shapiro, ALB, Starling, AP, Friedman, C, Felix, JF , Küpers, LK, Moore, BF, Hébert, JR, Shivappa, N, Scherzinger, A, Sundaram, SS, Shankar, K & Dabelea, D 2023, 'Maternal Diet Quality During Pregnancy and Offspring Hepatic Fat in Early Childhood: The Healthy Start Study', Journal of Nutrition, vol. 153, no. 4, pp. 1122-1132. https://doi.org/10.1016/j.tjnut.2023.01.039

TY - JOUR

T1 - Maternal Diet Quality During Pregnancy and Offspring Hepatic Fat in Early Childhood

T2 - The Healthy Start Study

AU - Cohen, Catherine C.

AU - Perng, Wei

AU - Sauder, Katherine A.

AU - Shapiro, Allison L.B.

AU - Starling, Anne P.

AU - Friedman, Chloe

AU - Felix, Janine F.

AU - Küpers, Leanne K.

AU - Moore, Brianna F.

AU - Hébert, James R.

AU - Shivappa, Nitin

AU - Scherzinger, Ann

AU - Sundaram, Shikha S.

AU - Shankar, Kartik

AU - Dabelea, Dana

N1 - Funding Information: The Healthy Start Study was supported by National Institute of Diabetes, Digestive, and Kidney Disease (NIDDK) grant no. R01-DK076648 and National Insistutes of Health (NIH) Office of The Director grant no. UH3-OD023248 to DD. This work was also supported by National Center for Advancing Translational Sciences (NCATS) grant no. UL1-TR002535 to the Colorado Clinical Translational Sciences Institute and NIDDK grant no. P30-DK056350 to the University of North Carolina Nutrition Obesity Research Center. CCC was supported by NIDDK grant no. T32-DK07658 and F32-DK131757. WP was supported by NCATS grant no. KL2-TR002534. KS is supported in part by grants from the NIH (P30DK048520, R01DK121497, and R01ES032176). The work of JFF and LKK is supported by the European Union's Horizon 2020 research and innovation program (874739, LongITools) and the European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL, NutriPROGRAM project, ZonMw The Netherlands no. 529051022 and PREcisE project ZonMw The Netherlands no. 529051023). Contents are the authors’ sole responsibility and do not necessarily represent official NIH views. Funding Information: The Healthy Start Study was supported by National Institute of Diabetes, Digestive, and Kidney Disease (NIDDK) grant no. R01-DK076648 and National Insistutes of Health (NIH) Office of The Director grant no. UH3-OD023248 to DD . This work was also supported by National Center for Advancing Translational Sciences (NCATS) grant no. UL1-TR002535 to the Colorado Clinical Translational Sciences Institute and NIDDK grant no. P30-DK056350 to the University of North Carolina Nutrition Obesity Research Center. CCC was supported by NIDDK grant no. T32-DK07658 and F32-DK131757 . WP was supported by NCATS grant no. KL2-TR002534 . KS is supported in part by grants from the NIH ( P30DK048520 , R01DK121497 , and R01ES032176 ). The work of JFF and LKK is supported by the European Union’s Horizon 2020 research and innovation program ( 874739 , LongITools) and the European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL, NutriPROGRAM project, ZonMw The Netherlands no. 529051022 and PREcisE project ZonMw The Netherlands no. 529051023). Contents are the authors’ sole responsibility and do not necessarily represent official NIH views. Publisher Copyright: © 2023 American Society for Nutrition

PY - 2023/4

Y1 - 2023/4

N2 - Background: Overnutrition in utero may increase offspring risk of nonalcoholic fatty liver disease (NAFLD), but the specific contribution of maternal diet quality during pregnancy to this association remains understudied in humans. Objectives: This study aimed to examine the associations of maternal diet quality during pregnancy with offspring hepatic fat in early childhood (median: 5 y old, range: 4–8 y old)Methods: Data were from 278 mother–child pairs in the longitudinal, Colorado-based Healthy Start Study. Multiple 24-h recalls were collected from mothers during pregnancy on a monthly basis (median: 3 recalls, range: 1–8 recalls starting after enrollment), and used to estimate maternal usual nutrient intakes and dietary pattern scores [Healthy Eating Index-2010 (HEI-2010), Dietary Inflammatory Index (DII), and Relative Mediterranean Diet Score (rMED)]. Offspring hepatic fat was measured in early childhood by MRI. Associations of maternal dietary predictors during pregnancy with offspring log-transformed hepatic fat were assessed using linear regression models adjusted for offspring demographics, maternal/perinatal confounders, and maternal total energy intake. Results: Higher maternal fiber intake and rMED scores during pregnancy were associated with lower offspring hepatic fat in early childhood in fully adjusted models [Back-transformed β (95% CI): 0.82 (0.72, 0.94) per 5 g/1000 kcal fiber; 0.93 (0.88, 0.99) per 1 SD for rMED]. In contrast, higher maternal total sugar and added sugar intakes, and DII scores were associated with higher offspring hepatic fat [Back-transformed β (95% CI): 1.18 (1.05, 1.32) per 5% kcal/d added sugar; 1.08 (0.99, 1.18) per 1 SD for DII]. Analyses of dietary pattern subcomponents also revealed that lower maternal intakes of green vegetables and legumes and higher intake of “empty calories” were associated with higher offspring hepatic fat in early childhood. Conclusions: Poorer maternal diet quality during pregnancy was associated with greater offspring susceptibility to hepatic fat in early childhood. Our findings provide insights into potential perinatal targets for the primordial prevention of pediatric NAFLD.

AB - Background: Overnutrition in utero may increase offspring risk of nonalcoholic fatty liver disease (NAFLD), but the specific contribution of maternal diet quality during pregnancy to this association remains understudied in humans. Objectives: This study aimed to examine the associations of maternal diet quality during pregnancy with offspring hepatic fat in early childhood (median: 5 y old, range: 4–8 y old)Methods: Data were from 278 mother–child pairs in the longitudinal, Colorado-based Healthy Start Study. Multiple 24-h recalls were collected from mothers during pregnancy on a monthly basis (median: 3 recalls, range: 1–8 recalls starting after enrollment), and used to estimate maternal usual nutrient intakes and dietary pattern scores [Healthy Eating Index-2010 (HEI-2010), Dietary Inflammatory Index (DII), and Relative Mediterranean Diet Score (rMED)]. Offspring hepatic fat was measured in early childhood by MRI. Associations of maternal dietary predictors during pregnancy with offspring log-transformed hepatic fat were assessed using linear regression models adjusted for offspring demographics, maternal/perinatal confounders, and maternal total energy intake. Results: Higher maternal fiber intake and rMED scores during pregnancy were associated with lower offspring hepatic fat in early childhood in fully adjusted models [Back-transformed β (95% CI): 0.82 (0.72, 0.94) per 5 g/1000 kcal fiber; 0.93 (0.88, 0.99) per 1 SD for rMED]. In contrast, higher maternal total sugar and added sugar intakes, and DII scores were associated with higher offspring hepatic fat [Back-transformed β (95% CI): 1.18 (1.05, 1.32) per 5% kcal/d added sugar; 1.08 (0.99, 1.18) per 1 SD for DII]. Analyses of dietary pattern subcomponents also revealed that lower maternal intakes of green vegetables and legumes and higher intake of “empty calories” were associated with higher offspring hepatic fat in early childhood. Conclusions: Poorer maternal diet quality during pregnancy was associated with greater offspring susceptibility to hepatic fat in early childhood. Our findings provide insights into potential perinatal targets for the primordial prevention of pediatric NAFLD.

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DO - 10.1016/j.tjnut.2023.01.039

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AN - SCOPUS:85150059699

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JO - Journal of Nutrition

JF - Journal of Nutrition

IS - 4

ER -

Maternal Diet Quality During Pregnancy and Offspring Hepatic Fat in Early Childhood: The Healthy Start Study

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